1. Field of the Invention
The present invention relates to the surgical treatment of isolated articular chondral defects and, more specifically, to methods and instruments for allograft transplantation of articular cartilage in the knee using round, size specific fresh hyaline cartilage grafts.
2. Description of the Related Art
Chondral defects, i.e. defective cartilage, of the femoral condyles can vary from superficial blemishes and fissures, to large, full-thickness defects. These lesions may also occur as isolated pathology in cruciate normal knees. In the past, however, treatment has been difficult and controversial. Thus, in many earlier known methods, other indications in the knee would be treated, but the chondral lesion usually was left untreated. This approach leads to lesion enlargement and ultimately an advancing arthritic condition.
More recently, chondral defects of the femoral condyles have become widely recognized indications which comprise approximately 5% of all knees undergoing arthroscopy. As such, chondral defects in the knee are typically treated by autograft transplantation of bone cores in the knee, as described in U.S. Pat. No. 5,919,196, the disclosure of which is hereby incorporated by reference. However, autografts cause additional intervention surgery, increased pain and infusion, and only provide a maximum of 2 or 3 cores to treat smaller focal defects. Furthermore, the donor core must be taken from a location different from the recipient site, thus preventing a perfect match in curvature of the cartilage surface.
As an alternative to the above-described autograft method of treating focal osteochondral defects, an allograft osteochondral transplantation method is known, in which a surgeon is provided with a whole cadaver knee from a tissue bank, along with an instrument set containing the full range of sizers and sized instruments. In this allograft method, the surgeon must determine the size of the graft needed and then harvest the properly sized allografts at the time and location of performing the surgery. This method is undesirable, however, due to several factors, including the preoperative preparation required for the surgeon to harvest and prepare the donor core, the waste from discarding each cadaver knee after the one operation without realizing the full potential for each knee to yield multiple allograft cores, and the comprehensive instrumentation system which must be sent to and recovered from the operation site.
Moreover, many times the surgeon will determine the presence of a chondral defect during treatment of another condition, and must schedule another surgery to repair the chondral defect. In such instances or in other situations when the surgeon is able to determine the size of the defect prior to the time of the scheduled surgery to repair the chondral defect, the surgery would be much less time-consuming and less burdensome on the surgeon if the surgeon could obtain an appropriately sized, ready-to-use donor graft, prior to the start of the surgery on the patient.
Accordingly, it would be desirable to provide a method of repairing chondral defects using allograft cores which are precut to the correct size and prepared for transplantation using corresponding instruments.
A first aspect of the present invention is to provide a service which significantly reduces the amount of work to be performed by a surgeon during a bone core transplantation surgery.
A second aspect of the present invention is to provide a streamlined and cost-effective service to facilitate the performance of an allograft core transplantation surgery.
A third aspect of the present invention is to arrange for the delivery of a precut allograft core to a surgeon or hospital prior to the performance of a transplantation surgery.
The present invention comprises a method for facilitating a hyaline cartilage allograft transplantation procedure in which a service provider, upon receiving an order for an allograft of a specified diameter, arranges for the delivery of a precut allograft core along with a customized set of instrumentation for performing the transplantation to the operation location prior to the scheduled time of the operation. The service provider also arranges for the return of any non-disposable instrumentation to the service provider after the operation.
Other features and advantages of the present invention will become apparent from the following description of the invention which refers to the accompanying drawings.